Afraid to Be Out-of-line, but I Think He Needs Autism Screening...

I haven't read other's responses, but I'd say, no, don't push it. You brought it up, she responded positively that time. I've had someone bring it to me about my own child, giving me a "he's autistic". He's not. This person gave me a firm diagnosis on her own, and labeled him severely autistic. No denial here, there's been evals and he's not autistic. Autism is a very "popular" diagnosis these days--its great that so many people are aware of it now, don't get me wrong. But--that doesn't mean that each child that appears to have it has it.

When my son was 3, his speech was very delayed, he was very crabby most of the time, and spent a lot of time going around in circles saying swoosh, swoosh. He is now 13 and has a bit of an articulation issue, is known as one of the most pleasant people in the school, and runs track. Not autistic at all. Some SID issues, but nothing too serious. I wish we'd gotten him evaluated sooner, but I'm just saying, it's not easy to make a diagnosis at 2 or 3.

As a friend I would tell her that she has to proactive for her child. The doctor only sees her child for a short time compared to how much time she spends with him.

Hi,

From a mom of twins on the spectrum, I would advise not to take it any further with your friend. I think you have done the right thing by mentioning it, and now I think its best to leave it in the hands of the parents. I know the feeling of wanting desperately to help other parents understand the importance of addressing the possible needs of a child who is exhibiting symptoms of autism. Early treatment (biomedical, diet, etc) can make a HUGE difference for the child. However, I would suggest allowing your friend to make her own choices, even though its hard for you to watch. She will ask you for you advice/support if she needs it, but the last thing you want to do is come across too strong and alienate her from you. Sometimes people become unwilling to talk to people about things if they feel that person is too strongly opinionated about the issue. Know what I mean? You have done a great thing by bringing it up, now try to trust that everything will be ok and take the course that it is meant to take. Besides, in another year it will more obvious as to whether or not there is truly a need to have this child assessed for spectrum disorders. Many typical children demonstrated autistic behaviors b/c that's a pesonality thing. So there is a possibility that he's ok, and just a little different in how he expresses himself. Once he is preschool-aged, teachers will decided whether or not he should be assessed, which is also helpful for parents, when the suggestions come from professionals.

Again I think you did the right thing! You're a good, brave friend.

Meg

s.

Mind your own business.

You're not a developmental pediatrician and they will figure things out for themselves.

You are not the parent. While I understand your concern, it is not your place.
My son is almost 2, and he too lacks social connection(because he is not socialized), possesses minimal verbal skills (normal for boys to progress slower), and loves to dance. Does this mean my son is autistic??? I don't think so, and neither does his Dr.

as a mother of a 3 and a half year old child with autism (asperger's syndrome), who had to fight for almost 2 years to get a screening...please tell your friend to see a specialist. i had a really hard time because my daughter has a huge vocabulary (she is 3 and tested at 8 years old for her receptive/expressive language testing), so even our family dr had a hard time getting past that to see her "warning signs" (flapping and toe walking when excited or angry, lining up toys and objects, lack of social connection with kids her own age, intense tantrums, rigidity to schedule and changes in routine, sensory sensitivities, lack of eye contact). but because she could talk in whole paragraphs by age 2, and was using words like "absolutely" "obviously" "apparently" "mystifying"
"ridiculous" (seriously, we were reading Wacky Wednesday and she said, "This picture is so obviously ridiculous."), no one wanted to even talk about the possibility of autism. the only reason i finally got the referral for my daughter to see the specialist was because she had a major meltdown right in the family dr's office. she had to go to the bathroom, and when i turned on the light the exhaust fan came on, and she hates that sound. and she freaked out...jumping around, flapping, screaming, totally out of control. so i looked at him, and he looked at me and very sheepishly says, "I'll make the referral..." the neurologist wasn't in the room with her for more than an hour or so and made the diagnosis, and it fits my daughter so well. and now she's in an inclusive preschool with a TSS and a behavior specialist and she has made huge leaps and bounds these past few months, and i don't regret pestering her dr at all. what i would've regretted would've been not sticking to it.

As much as I always loved my pediatrician(s), they DO have their limits & as a mom, I learned to trust my gut & subsequently went outside their practice scope for a few things concerning my kids. The 1st time, I had to say, I was hesitant because my trust in them was SO great (& 1 of them was outright angry, believe it or not).

My point is that, I agree that peds' expertise may not be as broad as they may like to think & that she should seek outside advice but you can't make her. Bringing up someone else's situation & what THEY did (as a mom wrote in here) may help to jog her into her own initiative of seeking outside testing. I think you, as a friend, can only do so much. It sounds like the both of you are on the same page, which is a massive start for her to hear your supportive & encouraging words.

This is a tough one, no doubt. Good luck to all involved!

Before you jump onto the Autism band wagon consider this. Is he an only child that doesn't go to play dates or a day care center? Some children do not speak at all until they are older...can he follow simple two step directions? Some kids like to jump and dance and prace around as well.
In my experience as the mother of 3, my youngest didn't speak until after her third birthday...then one day she just started talking in complete sentences! I had her screen for speech therpy once, and the school tested her twice...she was borderline all three times, but they felt no need or worry about her and she has progressed with no problems over the years.
I have babysat children that are "high energy" and they like to dance, prance and wave around like little crazy people when they are excited! One really great solution to this is getting the child involved in dance or gymnastic's when they are around the age of 3...it gives them a physical way to use up all that energy and teaches them body control and focus.
In today's world we are too quick to lable our children with Autism, ADD and ADHD. We are too willing to drug or find excuses for a child's behavior instead of being creative and teaching them how to play, how to read, how to behave...
In today's world our children don't go outside and play and run or ride their bikes like children of past generations because it isn't safe like it once was. But we as parents need to find the time to get our kids physically active and engaged in freshair and sunshine!! We need to quit comparing our children and make a better world for them one street, one block, one community, one county and one state at a time! We need to take the responsibility to make it better, safer and brighter for our children.

My nephew has Aspergers which is a form of Autism and it actually sounds a lot like him. I think I would ask another doctor so the child could get help now with his social skills. It never hurts to err on the side of caution even if the second doctor says no, at least she will have peace of mind. My nephew is in kindergarden and is in a regular class, and is doing well. Let me know if you need any more insight. I'm sure my sister would be happy to talk with her. My email is ____@____.com

Believe it or not, a lot of non-ASD children flap their hands, dance, or do something else to show their excitement. If this child has a speech or language delay, they will be more prone to the odd movements to express their emotions because they are lacking the verbal skills to tell you how they feel. Your friend's son might just need to be in a more social setting, and if he stays at home with his mother that could definitely cause the lack of verbal skills and social connection. My son stayed home with me for four years and after he started pre-school he changed completely.

If your friend is comfortable with what her pediatrician says than, unfortunately, there really is nothing else to do. My son's pediatricians kept assuring me that my son is non-ASD and it turned out that he has a speech and language delay which required him to go into an early intervention class. His teachers in that class say that my son has some red flags for Asperger's Syndrome, which is a form of very high functioning autism, but because of him never being in daycare they want to observe him for the next year to see if he outgrows some of this behavior.

I guess what I'm getting at is that autism is a VERY speculative disorder and just because one doctor says yes, the other one may very well say no. If your friend is confident in her child's doctor than that is her choice. If you really want to help her, than tell her about this website or cafemom.com. They have online support groups for mothers of children with speech delays, autism, Asperger's and any other topic you can think of.

Dear A.,
It's heartwarming to see you care so much for your friends, you are very special.
I am a gramma to a little fella who is 26 months old. I could see signs of autism by 13 months, but was afraid to voice my opinion. After much soulsearching, I told my daughter-in-law what I suspected, and she was seeing it as well. She was told by her pediatrican, give it time, he's fine, etc. In the 10 minutes she saw him, he appeared normal. My daughter-in-law had to insist for the evaluation. He has been in therapy at home since 18 months, and has just graduated to a group of 3 other little guys at Easter Seals. He has made progress, which we owe credit to the therapists, who lovingly, guide him.
I would ask your friend how her son is doing, if she is open to talking about him, gently and lovingly tell her about some of the options you have been given here. Early intervention does work, and testing is key. Then give her a big hug, and let her know you care. She needs a friend like you.

As a parent of mildly autistic twins, I'd say push the issue. One of the most effective treatments is early intervention. It could something other than autism, maybe a food allergy? Studies have been done on autism and diets-gluten and casein(dairy) can cause such behaviors and inhibit speech. When I mentioned something to our pediatrician about our sons' speech, I was told to wait until they were about three. Well, we had moved by then and had a new pediatrician. I brought it up again, and the pediatrician referred them for tests, which in turn, resulted in their diagnosis.
The tough thing about twins is the speech; twins are known for 'twinspeak' so it was a little harder to determine the speech issue because they were somewhat verbal-at least, with each other.
I wouldn't be comfortable with the doctor's answer. Has your friend mentioned any of the other behaviors such as flapping or other self-soothing behaviors? The social one is a little tricky too, because it would depend on the settings and how much interaction the child has had. (I've got a 17 year old with Asperger's-it could be Asperger's but I was told that's more of an emotional/educational diagnosis).
If insurance isn't an issue, get a second opinion and request a screening.

Many states offer free in-home testing. At the very least, the child could qualify for speech and/or developmental therapy. In PA, these state sponsored therapist will go to pre-school with the child to help him learn to connect with other kids. Search 'Early Intervention' in your area.

I think you are a very nice, concerned friend. But I think in the end that it is up to the parents to decide what is best for their children. You may be right and the doctor may be wrong but I think that you have said all that you can as any more might jeaopardize your friendship with this mom. I'm not sure who this doctor is but I do know that doctors are very used to seeing kids with Autism nowadays and diagnose it quite frequently. Maybe the doctor is just observing for just a bit to see for sure before putting the child or family through any screenings (not like I know what screenings are actually involved!). I have had several friends who have the exact "warning signs" you are citing and their children DO NOT have Autism. If you think your friend is open to your pursuasion of her child's sceening, then maybe you can talk about it again. But if you had a bit of a "so-so" or "cool" conversation about it the first time around, I'd let it go or risk your friendship. If there is one thing I know, Parents do not like to be told anything about their children...whether it's right or wrong! They automatically go on the defensive. But again, I don't know how good a friend she is to you. I could easily tell my best friend something like this but have other friends who I wouldn't dare try!
Good luck and best wishes to you and your friend as well. :)

A.,

i am a 35year mother of 4 and work in the field of autism. I absolutley agree with you! I would approach your firend and delicately express your concerns that the first 3-4 years are the most crucial in making advances in developmental progress with autism thorugh early intervention and wraparound services. Explain that she has nothing to lose by having some testing done through a developmental pediatrician/psychologist. If the reuslts come back negative then she has just confirmed what her pediatrician has stated and if not she can get her child the help he needs. Many children are diagnosed late due to similar reasons and are at a disadvantage. Good luck! A.

i have a friend who works with children with autism plus my friends son has it. she is in denial but if you feel that he has autism and your not satified with your doctor you should get a second opinion. it is your child and you should insist that the screening gets done. you are being a mother and need to put your child's need first. if you didn't say anything then what kind of friend would you be. what if it were your child.

We were in the same boat...except we were in MN and we saw the regular drs from Mayo Clinic (they have regular section to see the people who are residents in the area) and got a simular no not really as he is only showing one sign that could be autism or many other issues so lets get his hearing checked etc.

Have them call the IM for their county OR seek out a developmental pediatrition. We love ours (alothouhg we don't see her often anymore due to using a PDoc now that he is older for his needs) and she is wonderfully supportive and will be your regular ped too so when they are not feeling well that makes life easier as they know what they are like normally. If you would like her name and number let me know...she is fantastic!

MOST DRS do not really understand what early autism spectrum looks like...they just don't see enough of it (strange in a way but true)

This is tough because it is the parents decision. However, you can obtain information for them to review in order to make an educated decision. I would also focus on dietary intervention articles that they could safely try themselves to see if there is a difference in his behavior or lack thereof.

It never hurts to get a second opinion. I had to get several opinions over a period of years before finally getting to the source of my son's medical and mental problems.

God be with you and your friends.

As a former nurse one of the things I learned with my experiance as a med. professional and a patient doctors are not gods they are not the be all and end all. YOU must take control of you and your childrens medical treatment what ever it is. And follow your gut we have these "feelings" for a reason, it is God or who ever you choose to beleive in telling you no this is wrong and push. Every time I have not followed my gut I have been sorry. So I would tell your friend to tell her Doc. you know i value your apinion, but I feel it is in my childs best interest to have testing done by those who are experts in this field. I strongly incourage her to contact the kennedy krieger institute here is a link to their site they are awesome. I also strongly incourage her to look into nutritional options, what and how we consume plays a very big roll in so many childhood "disorders" so many of a chemical cause, and since this is one of those things that they still fight over the cause it cant hurt to try. I have a meeting to go to today but I will track down some info tonight when I get home and send you all I find. I will hold your freind and her child in my thoughts and have him added to our healing circle, all I would need is his first name. My thoughts are with your friend. You are a wonderful friend to not jsut sit back and not do anything, way to many people just dont get involved, we must all remember I takes a village to raise a child....

Brightest Blessings
Trish

oh and I forgot to say this...Moms you all sould know in case you do not, Your childs medical record is YOUR property, it does not belong to the doctor or their office. The law states it belongs to YOU. you have every right to read you and your childs medical record anytime you wish to. And I incourage you all to check you and your childs records on a regular basis, mistakes are made all the time. You are mis quoated and incorrect information is found in records all the time. I personally read my kids records at each visit. They now just hand it to me. Most will try and fight you on this but stand firm and tell them you know your rights and you want to see your property. I can track down the actual mandate if anyone needs it.

big hugs to all
trish

http://www.kennedykrieger.org/kki_diag.jsp?pid=1072

the same thing has happened to me and my son He is now 4 1/2 yrs and geting help from the IU. Please tell your friend if she is concerned to contact her local IU for a screening and possibly a full evaluation. My pediatrician said there was no way my son was autistic, even with the signs he was showing. I sent him to preschool (the following year) and the teacher said he had some indicators and we should go to our local intermediate unit for a screening. We did and he falls on the spectrum. Pediaticians see children once or twice a year for maybe a 1/2 hour, this is not enough for them to make a diagnosis unless it is severe. He could be high functioning and not have all the markers like my son. Good luck.

I am the proud parent of a 10-year-old son with Autism. His pediatrician never noticed a thing. Even when the school recommended that he be evaluated, the doctor still denied the possibility. The only professional that can make a diagnosis of Autism is a neurologist. Based on the symptoms you described I would say he definitely falls into the Autism or Aspergers spectrum. Your friend should find a local child neurologist and get him evaluated. As soon as he is diagnosed he qualifies to receive services from the school systems no matter what age he is. It is always a struggle to get schools to provide the services needed, but having the right services in place makes a huge difference. Last year my son couldn’t write a sentence and this year he had a story published in the school paper. To any parent facing Autism I say, educate yourself and fight for what you know is right because your child deserves it.

You are not out of line.

The first step is to contact the Chester County Intermediate Unit. Or the intermediate unit for your County.

I just went through the same process with my Son. My son is 4 and showed many of the signs of autism.

Once your friend contacts the intermediate unit, they will send her a questionaire. Based on the questionaire they will
send out people to evaluate his needs. For my son they sent out an occupational theripist, a physical therapist, a speech therapist and two other (behavior and developmental).

They also had me fill out questionairs for Aspergers and PDD (higher functioning forms of autism).

My son qualified as boderline austism and has delays in OT
PT and speech.

They also did a catch team assessment with a Developmental Psychologist from CHOP. This was Key because we were fast tracked. Normally if your friend were to call CHOP there would be a 9-12 month waiting period to get in for an initial evaluation. This entire process of going through Chester County Intermediate Unit took 3 Months and it is entirely FREE.

The next bit of good news is that he is getting FREE services.
Becuase he qualified for 3 or more areas of delays he attends the Early Intervention school in Downingtown where he receives all his services. If your friends son only qualifies for one or two services he may be offered them in the home. My son also attends a preschool at our church. So he has the benefits of specialists and going to school with kids that do not have special needs.

Two other very important things to for you to know, is that at the EI classroom they specifically develop and IEP for each child so if they are autistic, they work specifically with social skills along with a regualar preschool curriculum and additional services like OT and speech. And most importantly the earlier you start working with these kids the more likely they will be able to mainstream with kids w/o special needs.

So tell your friend if she were to contact the Chester County IU right now, she would probably be able to get her son services by this summer. They work year round. If her son qualifies for Early Intervention, they will bus her son both directions, so if your friend works they can bus him to daycare or where ever.

One last and very very very helpful peice of advice would be to run out and buy the book the "out of sync child". One thing that your friend will learn about through this process is about sensory issues. They affect both autistic and non autistic children and symptoms overlap with both autism and ADHD. This was something I could read and do something about immediately. They helped me realize that a lot of my sons behaviors were sensory seaking or sensory avoiding (he hates loud noises). There is a second book that goes with this book that gives activies to do with these kids. Both books are very hands on and will give immediate relief.

Good luck to your friend and she is welcome to communicate with me.

C. K
About me. I am in my 40's, I have a 4 yr old boy and a 7 year old girl, my daughter has NONE of these symptoms. I live in Downingtown near EAGLE. I have a MA in clinical Psych and worked as a Behavioral Specialist Consultant for 2 years before I decided to stay home full time (after my son was born). NOTHING Prepared me for my sons behaviors. I am still coming to grips with them and how to handle them. Please tell your friend it will get better and there are very real things you can do. Not all professionals agree on any diagnis and most likely her son't diagnoisis will change and not to get hung up on them. All a diagnisis will do is allow her to get the services she needs. What is important is that she trust her instincts! That she not rely on anyone doctor.
They are only as good as their last class and most of what they are learning about Autisim and Sensory is NEW- within the last 10 years. The sensory info is just now starting to be more excepted in the community. There are also some other good books to be considered from the biomed communities but this is a good place to start.

Good luck!

I would strongly advise your friend to take thier child to a developmental psychologist that specializes in autism. I work with kids on the spectrum and have a family whose second child started showing signs of mild autism. He's been evaluated by a variety of professionals (speech therapists, psychologists, etc) and no one has given him a diagnosis but i feel comfident as do some other professionals in the field that he is on the spectrum and have recommended that they take him to the same dev. psy. that their other son with the diagnosis goes to. Many professions miss the signs and the sooner a diagnosis is given or definitely ruled out the better

I have a Master's degree in special education with a concentration in autism. Autism occurs along a continuum- some children are more severely involved than others. Just because your friend's toddler doesn't exhibit extreme behavior doesn't mean he is not affected. A milder form is usually referred to as a Pervasive Developmental Disorder- Not otherwise specified. Please encourage your friend to seek another opinion. You are absolutely correct that early intervention is critical. She may want to contact her local school district as they may be able to assist her.

While parenting of any child should be left to the parent of the child, I think your concern and desire to push for a screening is from your heart. The spectrum of Autism is very broad with every child exhibiting different characteristics along that spectrum. Since the child is under the age of 3, an early intervention program would be free. Your friend has the authority to discuss with her pediatrician her desire to have for example, the Penn Foundation do a screening. I am in the administrative field of education with a background in teaching and as you know all children develop differently. If you happen to have a child the same age, do not do the compare game, because things such as speech, social awareness, expression of excitability all vary depending on the child's personality and gender. A screnning could rule out many things, including Autism. It could be that perhaps there is an issue of low muscle tone in the mouth and upper extremities. This would cause delayed speech due to improper tongue control as well as the inability to have more controlled hand and arm movements. For some children, the social piece does not click until they are consistently with other children everyday. Hope this helps you and your friend.

I know Montgomery County has free help for autism.. My son I thought had it and was tested. It was through Montgomery County Intermediate Unit. I was so glad I did. They said he had a slight case of it. It was good that we caught is so early because it is easier to treat the younger they are.. Tell your friend if she really feels that way to get a second opinion. It is so much easier to help the younger they are.

You've already gotten alot of varied answers, so I'll keep mine short. If your friend is not comfortable with the doc's answer, she should go see another doctor. I have gotten wrong advice from a doctor before, and it could have caused my son to need surgery. On the other side, all children develope differently. My oldest had a vocabulary of only about 20-25 words at age 2, but made honor roll all 4 marking periods last year in 5th grade. My middle child (9 y/o) knew probably about 75-100 words by 2 and possibly has ADD, but is borderline so nobody wants to make that diagnosis. It all comes down to how comfortable your friend is with this doc. and how she feels about his answer.

Dear A.:
My oldest son has mild Asperger Syndrome, which falls under the Autism spectrum disorders. This might be a possibility for the child you're describing. Please go to this web site and see if he fits any of these descriptions. http://www.udel.edu/bkirby/asperger/ The sooner he gets therapy, the better off he and his parents will be. Without early intervention, my son would never be the almost straight A student he is today in a regular 4th grade classroom and successfully taking up the vioin. The hardest part for parents is just accepting that your child needs extra help (and finding out where to get it) which is why I COMPLETELY disagree with anyone here who's telling you to mind your own business. If my son's pre-school teachers had thought that it wasn't their place to tell me their concerns about my son's behavior, I never would have had a clue how to get him some help. If the child's pediatrician doesn't offer help, suggest your friend contact an autism specialist in your area for a simple screening. You can find local specialists and family service organizations at http://www.autismspeaks.org/community/family_services
Best of luck to you and your friend!

Cudos to you for having the courage to talk to her about it. EARLY INTERVENTION IS SO IMPORTANT. I'm not comfortable with the doctor's answer. I remember when our pediatrician was concerned about the same characteristics that my older son showed at that age and we discussed it. He said it was probably developmental delays but he did not mention autism. Instead, he said let's get some testing done if he is not talking at 2 1/2. I too thought, no not autism. We did the testing at 2 1/2, but during that 6 months, RAINMAN was on TV. I looked at RAINMAN and looked at my son and said AUTISM to my husband. At 2 1/2, he was diagnosed with autism/PDD and we started services right away. Today, my son is 15 and in a charter school for kids with autism. He (and I) have grown so much and learned so much. He is self-sufficient, he is helpful, he loves school and volunteering at the food bank, and OH YES, he is non-verbal and uses sign language to communicate. He can read, write, and spell. He had his 7-minute Bar Mitzvah at age 13. It all starts with early intervention and listening to your gut feeling. Suggest that she check out my story on either of these websites:
www.discoverytoyslink.com/lenoremomkjpj OR
http://www.americasfavoritemom.com/mothers-day-2008/mom/L...
If she wants more recommendations for testing or information, I can give them to her. Press on lightly, one step at a time. I see signs of autism here.

It would really depend on the severity of those 3 signs. The lack of social connection would be the worst one. Does he really act like he is not interacting with people? I would think that the doctor probably knows best. I hate to jump to conclusions with children. Some doctors are so quick to put them on meds these days. It is good that the doctor is watching development, before saying he's autistic. It is also good that the parents know about it, and are watching it themselves. I am sure if they don't see a change or it gets worse, they will do something about it. You should watch too, and give it a while longer (maybe a year) and see what happens too.

Be pushy, pediatricians are not specialists. My son had trouble with balance. Oh it will get better, nothing wrong with him. At 2 years old, I said I wanted a referral to CHOPS. My son at the age of 3, was diagnosed with a rare genetic disorder, called Ataxia Telangiectasia. If I didn't pursue the issue, he too wouldn't have had early intervention. So, please pursue her to go to a specialist, the specializes in autism. At CHOPS they took one look at him walking and said something is definately wrong with my son. How could your pediatrician say otherwise. Hope this helps.

Most Peds don't know much about Autism. Your freind will find out if her child does have Autism or not in time. If the child does it will only get worse as he gets older. I found out my daughter had Autism when she was 3 but I had to push for the diagnosis. I wouldn't push your friend as I said it isn't going anywhere and sooner or later she will have to stop ignoring. It may be possible ehr child has a slight delay. In that case then the dr is right and the child would catch up. It's sad so many dr's know so little about Autism and are so unhelpfull to parents.

Dear A.,
Please keep pressing it!!! My son has a mild form of PDD and my in-laws were the ones to spot it. Sometimes the parents are too close and the pediatricians aren't sending people to get tested early enough. We took my son to childrens hospital in pittsburgh to get diagnosed. He has been in therapy for 6 months and has blossomed!!! You can get all the help you need if you just have the diagnosis. Does he recieve early intervention? If he is under 2 and just has delays they will give you free therapy in your home. Just have the Mom look up the county behavioral number in the blue pages in your phone book and they can give her the number of early intervention in your area. It's all about early detection. You are doing the right thing...just tread lightly. it is very hard to hear that your beautiful child has Autism. If you have any questions for me just e-mail me.
M.

If this child is under age three and the family lives in Allegheny County, mom can call the Alliance for Infants and Toddlers for a free evaluation in her home. ###-###-#### If you live in another county, contact any early intervention provider in your county and they will point you in the right direction. I am an early intervention providerl. This is a free service and takes a lot of the mystery out of diagnosing. Pediatricians are often not enducated in child development.

then can call up usually the local MH/MR and request a screening. The can also get a reg speech screening. Some of these can take weeks, months to get done. Once the kid is 3 then request screening by the local school district.

Yes its usually around age 2 or so can make autism diagnosis. Rather be safe then sorry.

My son is almost 5 and about to finally be evaluated after MONTHS of doctor visits, phone calls, and begging. It is not as easy to get help as one would think.
I knew there was "something" wrong with my son since last June. Month after month the family doctor ran blood work, wanted to write prescriptions, and when I ASKED for a psychological eval told me it was "your challenge as a parent to teach him to manage his personality quirks".
As I watched my son spiral downhill, I got the IU involved. Their initia eval had my son as 'appropriate and above average" for each way of development. His vocab and math skills are beyond average, but he can't function 'normally' (little obsessions and major meltdowns, sensory issues that are way out of control) - which you don't see at it's worst in a short observation period and he is smart enough to know he isn't behaving acceptably and sort of tries to keep a lid on it while around others. He hates to leave the house because of this.
I then waited 3 more months for a school psychologist to assess him, and at preschool for 2 hours, she didnt' notice anything that unusual. At 5 - it is too late. You must have a diagnosed disability AND require special education. We have neither and can't seem to get any help.
Finally a nurse at the doctor's office saw what I was talking about and broached it to me. And gave me referrals. To doctors that our insurance doesn't cover. $1,800 for an assessment is not doable right now. We've been paying for play therapy out of our pocket 2x per week...not cheap. Play therapy helps him cope with his frustration and it is the only thing I can find right now. The play therapist only does play therapy but doesn't diagnose. After a preschool teacher with years of experienced observed him in our home it took her all of 15 mintues to tell that at the very least he has Sensory Processing Disorder, and should be assessed to see if he is on the spectrum. We are finally on waiting lists at schreibers and for a pysch eval at a child psych place our insurance DOES cover. Meanwhile... we know he won't be able to handle kindergarten and are really worried about school starting. And we still have no diagnoses, therapies, or help.
We found a new MD this week and that is giving us great hope. We are 9 months into seeking help and struggling everyday. If you have to, have your friend email me or call me. Share my story with her. Her son sounds like he has MORE symptoms than mine did at that age. At that age...my son was had great verbal skills, great social skills and no hand flapping. The delayed verbal skills alone should trigger an IU early intervention assessment. The earlier these things get going the better for the kids. I know kids who were Dx'd as on the spectrum at 2 and by kindergarten that diagnoses was repealed!

My son did not demonstrate any issues until he was 4. If he had before the age of 3 and I could have got him in the Early intervention programs we would be so much better off, now.

You CANNOT depend on the medical system to look out for you. You MUST do your own research, read everything you can find, talk to as many people as possible.

In your shoes, I would just honestly sit down and as kindly as possible tell her that you really care about her and her family and you know you may be overstepping but in her shoes you would hope she would do the same for you. Get online and show her these posts... and then find the online autism checklists to show her that she can't rely on her doctor, and in today's world we moms have to be warriors for our kids!

The problem with ALOT of people is the ignorance of autism/autism spectrum disorders.......
I'm a mother of a 4yr dx'ed with PDD-NOS. He had verbal delay, and was ahead of everything else. My husband fought over this and I finally gave in to a early intervention screening. He was behind on alot more than his speech. They then in turn recommend seeking a formal eval via the Children's hosptial and that's where he was formally dx'ed.
IF your friend is still worried you can seek early intervention WITHOUT a doctor's order.
PED DOCTORS ARE NOT TAUGHT AUTISM IN MEDICAL SCHOOL. It'a s fact!
However with the rise of autism in america (1-150 are diagnosed) the are recommened to screen every child 2x before the 3rd Bday.
Most kids get dx'ed before 3 because of the "key" factors you had noticed in your friends child.
You thru it out there for her. IF she brings it up again, mention early intervention.
Children at this age are more "workable" in fixing issues. The window of opportunity is open for only so long.
I had to "divorce" alot of long time friendships due to the fact alot of people are ignorant to autism and what it is.
You can't sterotype this kids---believe me they are all different.

*you're a good friend.

Hi A.,
I just read your message and had to respond. I have 3 children, one on the way. My second son is almost 5. When he was around 18 months old I noticed some differences in his behavior which made me believe he had some spectrum of autism. The first thing I did was seek help where ever I could, as this was not something I even understood. It took me 3 doctors until I found one that was on my side, and has supported my choices, decisions and opinions, of my own son full heartedly.

My son was diagnosed with PDD (pervasive developmental disorder, high functioning and most mild form of autism. It was such a relief to have this because the doors began opening all around. I myself had to do a lot of the leg work, as doctors can only diagnose and recommend. I think the parent(s) truly need to become proactive and know this is not the end of the world.

My son has received a variety of early intervention services since 18 months old. He presently still receives them, as his needs change. He is in a "normal" pre-k program this year and will be in an integrated Kindergarten program next year. He will still get any services he needs.

I have recently joined an organization in my state and area that includes parents to be a voice in autism and this whole process. I wish you luck and hope that this has been helpful and inspiring.

Sincerely, C. B.

As the parent of a child on the Spectrum, I have to say that I value the people that spoke to me candidly, honestly and with love when we were first dealing with her diagnosis. My dearest friend approached me and although to this day she says it was the hardest conversation she has ever had (and she is a child psychologist!!!), her intervention and that of a pre-school director, allowed me to get help for my child at the earliest opportunity. My daughter is now 7 and in a regular education 1st grade environment w/support. Noone would be able to pick her out as the "special needs" child in that classroom. This is because of the early intervention that she received. My personal opinion is to go with your gut and speak candidly and carefully with your friend. Don't use "diagnosis" words that may or may not be accurate. She can make an appointment with a developmental pediatrician to have him looked at for developmental delays...it may not be autism. You will never be out of line if you are coming from a loving and caring place...more than likely your friend will know and appreciate this as she already senses something is not right...I wish you lots of luck. Let us know what you decide and how it goes.

A.,
My sister-in-law had the same "nervous" approach w/ me concerning my son last January 2007. She gave me a copy of the MCHAT test that asks parents and/or primary caregivers key questions to see if you notice warning signs of autism behaviors. Try this. It saved us. (I think you can download it or ask for it thru a doctor??) I had my son evaluated the following month and they said he had PDD (on the spectrum) Pervasive Developemental Disorder. He has since rec'vd Early Intervention services, Wraparound services and is now in a specialized autism preschool class 5 days/wk. He has SOARED. His speech, social and "stimming" behaviors have improved and we are now looking into biomedical treatment for him to "detox" his body from all kinds of heavy metals, etc. that we believe has been a contributor to his behavior. I live outside of Pittsburgh and I feel very fortunate to have the state services for him that we do. Encourage your friend to seek more advise. Possibly NOT a general pediatrician, but rather, a child neurologist or specialist that has better credentials to rule out the disorder. Hopefully, it isn't autism, but there could be worse things! You don't want the child to be overlooked for early intervention. It's the key to getting a head-start on this developmental delay. Best of luck and don't be afraid to approach the situation using kind words of concern.
M.

I am a mother with a child with autism. And I was the one who pushed the issue to have him evaluated further. I've always went with my gut instinct and even though the peditrican might not have been so convinced that he was showing signs of autism. I would definately keep an eye if not just to be 100% take him to a developmental pediatrician or contact S.A.M. and have an eval team come out. My son was just 2 when we confirmed what I already knew and early invervention was the key to helping him. He has made alot of progress in 2 years and I owe it all to the early intervention, Milestones, and BCIU staff and therapists.

I would do what my gut instinct tells me to do. I had to be completely out of line at four different doctor's offices in order to get a screening and referral for my child for an issue. Every doctor told me that I was being too cautious--go figure--he is my child! Turns out, unfortunately, I was right. Within a minute of walking into to see a neurosergeon I had a diagnosis. I believe that is why they are called specialists.

i feel like you are doing the right thing. this is always a touchy subject to bring up to anyone & it is hard to do or say the right thing. you've done what you can & i'm sorry to say that you may have to leave it up to the parents to take the next step. perhaps try once more & suggest getting the child evaulated by early intervention. if the child is close to becoming 3 & they are in bucks county contact the bucks county intermediate unit @ 1800 ###-###-####.
in order to get an actual diagnosis of autism she should go to a developmental pediatrician, that could take some convincing & the wait time for an appt. may be outrageous.
good luck!!

My advice to your friend would be to seek a second opinion. Any time you have a concern about the health of your child (or yourself). It never hurts to have another professional look at the situation with a fresh set of eyes. If multiple providers are telling your friend not to worry, then perhaps she should put her mind at ease, but I don't think she should stop at the opinion of one provider (who may or may not know very much about autism). She should seek out an expert in child developmental disorders and ask them to evaluate her child to see if further testing is indicated. It can't hurt to get a second opinion - she will never regret asking the question again - and again, and again, and again if necessary - but she might regret not asking it and missing out on the opportunities and advantages of intervening early with a child who has a problem that requires additional attention or therapy.

R. Leigh
Philadelphia, PA

I would tell her since she is worried to go in a nicely tell the doctor that she wants a Developmental Peds doctor to take a look at him. That will get him into a place that knows what to look for more so than a doctor that spends 10 mintues in the room with him. Doctors tend to say wait and see alot. Mine did the same thing and we missed out on so many early services for my son. I had to finally go in a tell her I really wanted to see a Development doctor because my 2 1/2 year old still wasn't saying more than 10 words. She thought he was just shy and he ended up being diagnosed with Apraxia and PDD_NOS.

It may not be autism, but one of the other disorders on the autism spectrum. The problem is that screenings may not produce an absolute diagnosis either, especially at this age. My son had several evaluations (age 5, 7). The 1st evaluation took 2 days. On the first day, autism was mentioned, but on the second day that was ruled out due to his intelligence. He was diagnosised with ADHD at the age of 7. When he was 12, the diagnosis was changed to Asperger's Syndrome. Luckily for us, he has a mild case and is doing well in school. Social issues are more difficult. However we've been lucky that he's had middle school classes with the same group of children which has helped even though he's far behind his peers.

It's a delicate situation with your friend. I would see if the subject comes up again when you're together, but don't start it yourself. See if your friend brings it up.

A. D

This mom does not have to rely on her doctor to take the next step. Contact the school district to find out who has jursidiction over the birth to 3 group (in PA it is MHMR or mental health mental retardation). That agency can point you in the right direction.
You can also contact you local autism awareness group for help. The earlier a diagnosis is made, the earlier intervention can implemented.
I had an aide in my early intervention classroom and from the time her son was 6 months old she thought there was something wrong with his hearing. The sweet old doctor assured her he was fine. At three years old he was diagnosed as profoundly deaf when the same doctor saw him lay his ear to the floor to feel the vibrations as the boy played with the doctor's very own grandaughter. All the previous symptoms were dismissed as only child syndrome.
Mothers have to remember that they know their children better than anyone.

This is a very delicate subject. I know your heart is in the right place, but I wouldn't push the issue. My 5yr. old is developmentally delayed and I've had to deal w/ some insensitive people. Some have suggested autism, others (plural) have said "definitely not". I would suggest you just be a great friend. And PLEASE! Don't stare or look worried around your friend. Trust me, parents of children who are different get that alot and we're very aware of it. Just treat him as any other child. That's what I want for my son.

I am a speech pathologist, working in the area of early intervention (birth to three). Whenever in doubt, I highly encourage families to have a thorough assessment if they have any suspicions of Autism. As you mentioned, an earlier diagnosis means a better recovery for the child. And if nothing else, for the parent, at least they can then have peace of mind, whether or not their child is given a diagnosis. Insurance generally covers the assessment, and those assessing the child have seen MANY children and know what to look for. I believe pediatricians are doing their best to help parents, but a 15 minute visit in the office is not a thorough assessment. Now a days, they are able to diagnosis children as early as 18 months. The line I use with parents all the time now is, if you are feeling at all uneasy, have your child assessed "for peace of mind."

I would tend to agree with you on demanding a screening. Not just for autism but any one of a number of possible diagnosis. A previous neighbor of mine has a little boy and about 2 years ago (at the age of 3) they found out he had Ausberger's Syndrome (sp?). What they thought was "bad behavior" and lack of verbal skills was finally diagnosised. He tended to copy and repeat alot of things he heard on tv...which hindered his abilty to communicate and frustrated him terribly. This in turn led to acting-out. If this is her first child she may be hesitant to demand a screening feeling like the doctor has more experience in such matters but one of the biggest lessons I've learned being the mother of 5 is to TRUST YOUR INSTINCTS! If something is not right you need to find out what is wrong...you are your child's voice. And early intervention can go a long way in shaping a child's future.

T.

I will admit that you have a bit of a perplexing issue and that I am a proponent of psychology and psychotherapy. However I will always agree on getting second opinions. Any physician or clinician period that says the word absolute in their diagnoses is out of bounds. There are no absolutes in any type of medical/psycho/pathological diagnoses.

With the said I would caution you about a few things. Autism is often over diagnosed as it resembles several other conditions. Some of these conditions result from pre-natal development, complications at birth, oxygen levels in the brain, neurotransmitter anomilies, decreased or interupted synoptic activity, and so on. It is possible that the child is mildly reteadrd (having an IQ of just over or under 60), a savaunt, or simply slow in psychological development. It could also be the exact opposite. The child could actully be a genuies, or protigal child. These children often display limited or slow development. Albert Einstien was considered as retarded until he was late into prepubesents. Walt Disney was also considered as mildly retarded.

I do think you are on the right track in suggesting screening and testing but please do not presume that slow or limited development automatically means there is a mental, psychological, or physical ailment or disorder. From a psychological perspective the child may be developing personality disorders or is simply deaf. There are too many possibilities to make a proper diagnoses with out testing.

Good luck

giving advice to friends regarding their children is ALWAYS tricky, but especially when it concerns their developmental well-being. i am a home childcare provider and have been in the same exact scenario with a former daycare parent - i did as you and verbalized my concern, which brought on an angry response and subsequently, them taking their child out of my care, only to receive a call several months later thanking me because they eventually had him screened for autism and he was diagnosed with aspergers syndrome (a mild form of autism)...HOWEVER, i've also recognized the same warning signs in several of my other daycare children over the years, all of whom have developed into "normal", well-balanced children...while you may feel her pediatrician may be missing the diagnosis, at this point, i think its important for you to sit back and allow your friend to make the decision whether or not to pursue the issue....the pediatrician may have seen something you have not and may see the developmental progress from the childs previous appointments...the fact that it was brought up to the doctor in the first place is important, and you can always "delicately" ask your friend how the childs progress is going WITHOUT bringing up autism - ask her "is he saying anything new yet?" or "whats (he) up to these days?"....if you feel your friend is indeed in any type of denial, you could always say to her that she may want to reconsider talking with the doctor again about her concerns and she need to ask for further confirmation and explanation as to why the child doesn't necesitate evaluation by an early intervention specialist....but don't be overzealous - as you said in your email, with all due respect, you are not the expert and the childs doctor is probably right....you don't want to alienate your friend because of this! it sounds like she has a very caring friend in her corner in the case her child indeed needs some help! good luck.......

Hi A., Im a professional in the field of communication disorders with a lot of experience with kids with Autism. Im also a mom of 2. I can appreciate your concern, considering the syptoms that you list here. So I say, suggest to them that they treat the symptoms now, deal with the overall developmental diagnosis if necessary later. It's often easier and more crucial for a family of a preschooler to address the language issues first. I know first hand that early intervention is so powerful to overcoming the challenge of language delay, and language delayed children may retreat socially so that the whole thing masquerades as Autistic spectrum disorders, so identify and treat the language first, no matter what the diagnosis is. I think maybe your next suggestion should be a communication evaluation with a speech-language pathologist. Let that professional determine the degree or severity of delay, make appropriate recommendations on the communication aspect. She/he will likely suggest therapy if the child is 25% behind age level according to standardized tests. Most insurances pay for this. Then they're in professional guidance and that professional can observe and recommend and collaborate with the MD to refer for any further appropriate diagnostic tests. Easter Seals does free screenings, the Intermediate Unit in your county does screenings, the Children's Institute is excellent (Im biased, I worked there)and there are lots of satellites, Childrens' Hospital is excellent. There are private practice therapists in your area as well. I think you should do some research before you talk to her again, so that you can say you've found some places she should call- that shows her that you really care- and then once you've provided the family with your suggestions for speech therapy evaluation- then I think you've done all you can for now and you have to leave it in their court. I hope this is helpful. Good luck. Your care and concern for their child, expressed lovingly, is a mark of real friendship.

I don't think that I would be comfortable with that without some further explanation from the doctor. I, as a parent, would be saying to this doctor how she can be so sure it isn't Autism and what she thinks is going on with the little boy.

That being said, I do know that from what you've explained, there is a good chance the doctor is right on. My friends son displayed very similar signs. However, his problem was a speech delay. There was also the fact that he was a boy living with 2 sisters. Also, his mom ran a daycare in her home and just as a matter of circumstance all the children she watched were girls as well. He was really into traditionally boy things and just didn't really want to play with the girls and "girls" toys (ex. polly pockets and barbies). He liked to dance and would flap his arms when he was excited. With his speech delay, it was his way of trying to communicate how he was feeling.

But as I said, if she is overly concerned, as a parent I would recommend she talk to her doctor in greater depth about her son. Ask the doctor what she thinks is going on and since these things are warning signs of Autism and he seems to be a bit behind in things, what are the doctors thoughts and can they have him screened for developmental delays, learning disabilities and such. Have her tell the doctor she knows that with many problems such as learning disabilities, delays and Autism, early intervention has been shown to help immensely and she wants to get her son where he needs to be to succeed in school and life.

Best wishes to your friend and her son that everything works out in their favor. I hope my opinion and information is helpful to you and your friend.

I think you should follow your feelings. I am a teacher for children with autism and it is such an unfortunate diagnosis, but early intervention is absolutely important. Better safe than sorry. Unfortunatly many peds get very defensive over the simple term "autism" and just brush it aside. You'd think they'd be more willing to do whatever it takes to prevent it since so many children are diagnosed. Ok, I've rambled enough...bottom line...pursue it further until YOU are certain it is NOT autism.

Was this child premature? Premature children tend to have senory problems which can cause children to act this way to an extent. Sensory issues are a big hurdle and the most helpful to address if your child has autism. She needs to take her child to a development pediatrician. All the regular peds told me my son had anxiety but never said "do this" The developmental ped told me my son had aspbergers, tourettes and OCD. None of the other doctors mentioned any of these disorders. They aren't trained too! Take the boy to a Medical Center and see a specialist. If your fears are true don't be afraid. You must be your childs advocate. He will need a therapist and Most importantly an OCCUPATIONAL THERAPIST. They make the differnce because they work on the sensory issues. Once he is on a senory diet he will respond more. This is your chid, don't be embarssed. Addressing the issues ensure your childs future. Please don't wait until school starts, it will bring tears and set your child behind the others. Good Luck. PS You would know my son had Austism from looking at him.

I would have gave my right arm for someone to tell me that they thought my son had autism. He was diagnosed at 2 1/2 and I lost early intervention time that I can never get back.

One--Go to http://www.aboard.org/ and on the bottom right side is Forepath- online autism screening test.

Two--http://www.autism.com/ari/atec/atec-online.htm

Mom and Dad shouls each do one and they can check
"Not Evaluating a Specific Treatment and Not yet diagnosed"

There is no charge to anyone who wishes to use the ATEC. You may make as many copies as you wish, from the form that we enclose, or from the Internet.

Scoring the ATEC is also free. You simply enter the responses to the ATEC form on the ATEC scoring template on the Internet, and you will instantly be provided both a Total ATEC score and the scores of the four subtests which make up the ATEC:

I. Speech/Language/Communication
II. Sociability
III. Sensory/Cognitive Awareness
IV. Health/Physical/Behavior.

M.

I agree with Rhonda B. You are a wonderful friend to care so much! I am the mother of two special needs children, one of which is an Aspie (Asperger's Syndrome - an Autism Spectrum Disorder). It took a loooonng time to have him diagnosed and I now realize that although I had concerns, I probably should have insisted on having him tested long ago. He is now 14 and struggling with his new diagnosis and trying to fit in at high school.
Mom and/or Dad may have to insist on having him tested by a specialist, not just a "pediatrician" because they are not experts in Autism Spectrum Disorders. The child will have to be observed for more than just a few minutes. It is much better to have them diagnosed and treated at a young age than to wait. The sooner they can get started with therapy, the easier it will be for the child to learn new skills and adapt in a social setting. Medication is not the only answer if it turns out to be Autism, the child will need a lot of therapy from professionals as well as the parents. Mom will also need a LOT of support from her friends if the diagnosis turns out to be what is suspected. I wish you luck in talking to your dear friend and I'm sure she will know that you are genuinely concerned. If you know someone else who has an Autistic Child, it may help to pick their brain for advice on how to talk with Mom also.

I am a local daycare provider and have the majority of my daycare with developmentally challenged children. I in fact have one child whom has a type of Autism (PDD), therefore I recommend a pediatric developmental specialist, however you will find that a lot of the time it is not a clear diagnosis even from the specialist. I have the brother of the child mentioned above who is the same way (very minimal speech, currently sees an Occupational Therapist and a Speech Therapist both once a week and the developmental specialist did not give a definitive diagnosis). Tell your friend to not give up and if anything seems "off" to keep going back to the specialists. There are also a lot of free and very cheap conferences and workshops for parents regarding a lot of these issues in the area.

Your friend can contact her local educational service agency for an autism screening under Early Intervention services. You do not need a medical referral. A PARENT CAN AND OFTEN DOES REQUEST based on preschool or friends/relatives suggestions! Call your local school district to find the agency that handles Early Intervention screenings. In our area, one agency handles children under 3 and another handles from age 3 on.
Be persistent!
Is there a local Autism Society group to guide them in the process?

You've already expressed your concern and the parents are aware. Doing anything else is crossing the line.

Stay out of it. If they are the type of people to even ask the doctor about it in the first place it is not your place to press it. All you can do as a friend is support the parents decisions or walk away if you don't like it.

Sorry to be so harsh but it is the truth.

I learned one very important thing going through the Early Intervention system with my son...many pediatricians are opposed to having EI evaluations unles they are absolutely necessary (in our case, my son did not walk and was completely non-verbal at 18 months so she pretty much HAD to recommend that he be evaluated as he was at the far end of the "accepted" waiting time for these skills to develop). The reason for this is that many doctors feel that if something is found wrong with a child through EI (or even the LIU as they get older) the doctor missed it - and it is almost an ego issue...if they don't send them, what they missed won't be noticed. Sadly, this is absolutely NOT in the best interest of the child!!! This has nothing to do with the child or the parents - it is all about the doctors. Please don't take this as bitterness from me - this is what I was told over and over by the numerous therapists my son saw during his time with Early Intervention.

That said...my son spent nearly two years with doctors and specialists for a variety of issues, concerns and problems. The best diagnosis anyone could come up with was that I was a bad parent and was doing something wrong. Within two weeks of working with the Early Invention therapists, three different therapists in three different disciplines all found his behaviors to be sensory related. The end result? My son has severe (extremely severe) Sensory Integration Dysfunction. Many doctors don't put much stock in SID as anything more than finkicky behavior -something kids will grow out of - it couldn't possibly be related to XYZ - in our case, it absolutely was. He did not eat because he did not feel the sensation of hunger. He did not sleep because he physiologically did not get tired.

So...all of that said...evaluation through Early Intervention is free and the therapists look at things through a different set of eyes than medical doctors - more than anything they try to look at the child through the parents' eyes! They come to the home and watch the child in their natural environment - not a sterile and unfamiliar office setting. There is no harm in taking the extra step. There is great relief if the therapists agree with the doctor - and great comfort if they don't - because, as a parent, you don't feel crazy.

Finally (and again, this is from ALL of the numerous therapists my son worked with through EI), the earlier EI gets involved, the better the child is in the long run!!! If evaluation is delayed because the doctor wanted to wait out the maximum acceptable time limitations...the child is the one who loses out. In our case, we didn't know about EI until our son was referred for evaluation...so we were not making educated decisions in many ways and perhaps he could have been in better shape earlier - he was certainly a much different child almost immediately once he started working with people who understood him (and me). I now tell EVERYONE I meet about it - and about the extensive services they offer. Unfortunately, we are not the only parents who didn't know about the services until it was absolutely necessary.

Just my two cents...